KETAMINE VS DEXMEDETOMIDINE AS AN ADJUNT TO LEVOBUPIVACAINE AND DEXAMETHASONE FOR LUMBAR TRANSFORAMINAL EPIDURAL INJECTION USING HYBRID TECHNIQUE OF ULTRASOUND GUIDANCE + FLUOROSCOPY – A SINGLE CENTERED OBSERVATIONAL STUDY.
Main Article Content
Keywords
Low back pain, Transforaminal injection, Ketamine, Dexmedetomidine, Oswestry Disability Score
Abstract
Introduction: Low back pain is most common in middle age group, which is usually due to nerve root inflammation for which primary treatment often involves medication, physiotherapy and lumbar transforaminal epidural steroid injection. Debate continues regarding the supremacy of one adjuvant over the other in prolonging the analgesic action of lumbar transforaminal epidural steroid injection.
Objective: The present study aims to compare the efficacy of ketamine and dexmedetomidine as an adjuvant to transforaminal epidural injection in terms of pain score, Quality of Life and side effects.
Materials and methods: This single centered study was conducted among a total of 80 patients with chronic low back pain of either sex, aged 18-65 years, with not more than one level of bilateral lumbar foraminal disc protrusion causing radiculopathy were enrolled. Patients who received 10mg of preservative free ketamine were in Group K and those who received 10mcg dexmedetomidine were in Group D, as an adjunct to 2ml of 0.125% levo-bupivacaine with 8mg of dexamethasone. Assessment of Pain was done using Visual Analog score for 24hrs, Quality of Life using Revised Oswestry Disability Score (RODS) at the end of 1,3 and 6 months.
Results: Analgesia and quality of Life improved more in Group D than Group K by the end of 3 months (p=0.024) and 6 months (p=0.009).
Conclusion: The analgesic efficacy of adjuvant therapy with dexmedetomidine is superior in prolonging analgesia and quality of life.
References
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Dr. Swathi Gundlakunta
DNB, Assistant professor, Narayana Medical College, Nellore, Andhra Pradesh, Dr.NTR university of health sciences.
Dr. Busetty Prithvi Raj
MD, Associate professor, Narayana Medical College, Nellore, Andhra Pradesh, Dr.NTR university of health sciences.
Dr. Chaithanya Kumar
MD, Assistant professor, Narayana Medical College, Nellore, Andhra Pradesh, Dr.NTR university of health sciences.
Dr. Paavani Andagala
Postgraduate, Narayana Medical College, Nellore, Andhra Pradesh, Dr.NTR university of health sciences.
Dr. Haritha Damarla
MD, Assistant professor, Narayana Medical College, Nellore, Andhra Pradesh, Dr.NTR university of health sciences.
Dr. Krishna Chaithanya
MD, Professor , Narayana Medical College, Nellore, Andhra Pradesh, Dr.NTR university of health sciences.